Step therapy policies, also referred to as “fail first,” require individuals to try and fail on less expensive treatments, sometimes with adverse effects, before the insurer or pharmacy benefit manager will cover the prescribed treatment. Step therapy policies can be unethical and inconsistent with standards of care, resulting in interference with the practitioner-patient relationship and significant delays in access to prescribed treatments.
States have introduced legislation to address step-therapy. Please click on the map below for state-specific information on legislation introduced this session.
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